1023025343 NPI number — MRS. BRITTNEY GRACE HUGHES PA-C

Table of content: MRS. BRITTNEY GRACE HUGHES PA-C (NPI 1023025343)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1023025343 NPI number — MRS. BRITTNEY GRACE HUGHES PA-C

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HUGHES
Provider First Name:
BRITTNEY
Provider Middle Name:
GRACE
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
PA-C
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
DEFELICE
Provider Other First Name:
BRITTNEY
Provider Other Middle Name:
GRACE
Provider Other Name Prefix Text:
MISS
Provider Other Name Suffix Text:
Provider Other Credential Text:
PA-C
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1023025343
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/21/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
360 GREEN ASPEN CT
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MILLERSVILLE
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
21108-1871
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
410-874-7395
Provider Business Mailing Address Fax Number:
443-393-0215

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6518 MEADOWRIDGE RD
Provider Second Line Business Practice Location Address:
SUITE 106
Provider Business Practice Location Address City Name:
ELKRIDGE
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21075-6403
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
443-393-0223
Provider Business Practice Location Address Fax Number:
443-393-0215
Provider Enumeration Date:
08/01/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363AM0700X , with the licence number:  C0003324 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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